Individual
MS. LISA MARIE KLENNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
1000 E MAIN ST, DANVILLE, IN 46122-1948
(317) 718-4764
Mailing address
1101 SASSAFRAS TRL, GREENWOOD, IN 46143-6859
(317) 513-2092
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26020419A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26020419A
INDIANA PHARMACIST LICENSE
IN
Enumeration date
02/16/2021
Last updated
02/16/2021
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